Wednesday, July 6, 2011

Policy Change: President to Send Condolences Following Suicides

President Obama announced today that he would change the long-standing practice, in existence at least since the Clinton administration, that the President does not send a letter of condolence to families of servicemen and women who die by suicide, even in a combat zone. Obama will begin to send such letters, just as he does to families of military members who are killed in action. Obama said he was making the change to emphasize that people who need mental health care in the military are not weak and should not be stigmatized.

I first wrote about this issue in November, 2009, when the drive to change the policy was relatively new. Since then, I have begun working with veterans with PTSD directly, and have a lot more first-hand knowledge of what the state of mental health care and stigma is in our armed forces. When I went back to read my thinking from 18 months ago, however, I found that it really hasn't changed much. There were pros and cons then, and there are pros and cons now. So I'm reprinting my original post, below.

I want to make it absolutely clear that I fundamentally believe that deaths by suicide are, without question, service-related and/or combat-related deaths. My ambivalence about this policy comes not out of any desire to stigmatize these families or lessen the importance of the sacrifice, but rather out of my number one priority, which is to prevent as many of these deaths as we can.


Wednesday, November 25, 2009

Should the President Send Condolences When a Soldier Kills Himself?

If your loved one dies while serving in the United States Military, whether they are killed in action or by accident, you will receive a letter of condolence from the President.  Presidents have been doing this since Abraham Lincoln.  If your loved one serves in the military and kills themselves, however, you will get many of the same things that other families get, but you will not receive a letter from the Commander in Chief.  That has been true at least since the Clinton administration.

There is a push on from some military suicide survivors to change that policy.  They argue that their loved ones died in service of their country, certainly as much as someone who was killed in an accident.  The injuries they suffered were not visible, but they were certainly service related.  Their families deserve the same consideration from the President as anyone else's, and to do so would go a long way towards reducing the shame that has for so long been associated with death by suicide, particularly in the military.

This is one of those issues which, spun the way these families and the press coverage are spinning it, seems pretty clear cut.  Of course being a suicide survivor should not have stigma associated with it.  These families are grieving just as much as any other, and deserve all the support we can give them.

There is a problem, however.  One of the rules of thumb in responding to a suicide and memorializing people who die by suicide is that you in no way want to glorify the act of killing yourself.  When you have grand ceremonies to honor their memory, you run the risk that someone else who is considering suicide will, consciously or unconsciously, view killing themselves as a means to get that kind of attention for themselves and their families.  This is probably more of an issue with teenagers, who aren't fully able to appreciate the consequences of any action because their brains are not yet fully developed, but it remains an issue for others, too.

I don't know that I have a good answer for this.  On the one hand, families who are survivors of military suicides should not be treated with any kind of stigma.  They deserve our honor and support in a very, very difficult and complicated time.  On the other hand, there is an argument to be made that even what is already done for these families --  receiving a folded flag, a 21 gun salute at the funeral -- let alone a letter from the President might look pretty appealing to a soldier considering suicide.  They might think that in death they can bring honor to their family that they feel they could not bring in life. 

Taking away the stigma associated with suicide in the military may well save lives by making soldiers more willing to seek help.  The question is, by honoring grieving families properly, how many lives will we lose?


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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